Vaping and prediabetes: A large US analysis links e-cigarette use to an increased likelihood of prediabetes, with the highest risk seen in people who both vape and smoke traditional cigarettes.
The study, published in AJPM Focus, examined more than 1.2 million data points from a CDC telephone survey to assess associations between nicotine use patterns and metabolic outcomes.
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Compared with nonsmokers, exclusive e-cigarette users were 7% more likely to report prediabetes, an estimated 7,000 additional cases per million users. Exclusive combustible-tobacco users were 15% more likely to have prediabetes, while dual users (vaping plus cigarettes/cigars) showed a 28% higher likelihood. Dual use was also linked to a 9% higher risk of diabetes itself, exceeding the 7% increase seen with exclusive smoking.
Risks varied by weight and race/ethnicity: e-cigarette users with overweight or obesity had greater odds of prediabetes than leaner users, and elevated risks were observed among Hispanic, Black, and Asian respondents compared with White respondents.
Researchers cautioned that the findings are observational and rely on self-reported data, limiting conclusions about cause and effect. A short follow-up also prevents insights into long-term changes. Still, the authors say the results, drawn from a large cohort, underscore potential metabolic impacts of vaping at a time when e-cigarettes are marketed as “safer” alternatives to smoking.
Lead author Sulakshan Neupane of the University of Georgia said the data suggest e-cigarettes “elevate the likelihood of prediabetes,” with dual use adding “compounding harm,” and called for broader evaluation of vaping’s effects beyond respiratory health.
